Expansion
Nodes follow the arteries, coeliac, superior mesenteric and inferior mesenteric groups
Expansion
- Foregut → coeliac nodes
- Midgut → superior mesenteric nodes
- Hindgut → inferior mesenteric nodes
- All three drain into the para-aortic (lumbar) nodes and then the intestinal trunk to the cisterna chyli
Other territories worth separating:
- Kidneys, adrenals, gonads → para-aortic nodes directly (at L1 to L2), reflecting their embryological position
- Lower limb and perineal skin → inguinal nodes
- Testis → para-aortic, not inguinal
The final common path is the thoracic duct to the left venous angle, which is why abdominal malignancy classically enlarges the left supraclavicular node, Virchow’s node, giving Troisier’s sign.